Private Health Information Statement - Combined policy

Vital Hospital (Bronze+) $500 excess & Ultra Extras

Monthly Premium

$682.85 #

(before any rebate, loading or discount)

Covers two adults & dependants, including non-student dependants (3 or more people, only 2 of whom are adults)

Available in Western Australia

# You may be entitled to an Australian Government rebate on the above premium. Your premium may also include a Lifetime Health Cover loading, an age-based discount or an insurer discount. Check with your insurer for details.

This policy covers children, students up to and including the age of 31 and non-students up to and including the age of 31, as well as persons with a disability who qualify as a child, student or non-student in these age ranges.

Hospital cover

This policy exempts you from the Medicare Levy Surcharge.

This policy provides accident cover and benefits for travel or accommodation (outside of hospital) - check with your insurer for details.

This policy includes cover for

Hospital Cover Legend
Back, neck and spineEar, nose and throatMiscarriage and termination of pregnancy
BloodEye (not cataracts)Pain management
Bone, joint and muscleGastrointestinal endoscopyPalliative care
Brain and nervous systemGynaecologyPlastic and reconstructive surgery (medically necessary)
Breast surgery (medically necessary)Hernia and appendixPodiatric surgery (provided by a registered podiatric surgeon – limited benefits)
Chemotherapy, radiotherapy and immunotherapy for cancerJoint reconstructionsRehabilitation
Dental surgeryKidney and bladderSkin
Diabetes management (excluding insulin pumps)Lung and chestTonsils, adenoids and grommets
Digestive systemMale reproductive systemHospital psychiatric services

This policy does not include cover for

Hospital Cover Legend
Assisted reproductive servicesImplantation of hearing devicesPregnancy and birth
CataractsInsulin pumpsSleep studies
Dialysis for chronic kidney failureJoint replacementsWeight loss surgery
Heart and vascular systemPain management with device

The benefits paid for hospital treatment will depend on the type of cover you purchase and whether your fund has an agreement in place with the hospital in which you are treated. See ‘Agreement Hospitals’ on privatehealth.gov.au for which hospitals have arrangements with your insurer – https://privatehealth.gov.au/dynamic/agreementhospitals.

Under this policy, you may have to pay out-of-pocket costs above what you get from Medicare or your private health insurer. Before you go to hospital, you should ask your doctors, hospital and health insurer about any out-of-pocket costs that may apply to you.

The following payments may also apply for hospital admissions

Excess: You will have to pay an excess of $500 per admission. This is limited to a maximum of $500 per person and $1000 per policy per year.

Co-payments: No co-payments

The following waiting periods for hospital admissions apply to new or upgrading members

Waiting periods:

  • 2 months for palliative care, rehabilitation and hospital psychiatric treatments, even if pre-existing
  • 12 months for other pre-existing conditions
  • 12 months for pregnancy and birth (obstetrics)
  • 2 months for all other treatments

Gap Cover

This provider offers 'known gap' or 'no gap' cover for medical bills for this product.

The Medical Costs Finder lets you find out more about the cost of specialist medical services.

Other features of this hospital cover

If you are young and healthy and are not planning a family, this cover may be for you. Benefits for some hospital services are restricted or excluded to keep the premium more affordable. No excess applies for Dependent Children up to and including 21 years

General Treatment Cover

By using this health insurer's "preferred providers" you will have lower out-of-pocket costs on selected allied health services and have access to more "no gap" services. See https://www.queenslandcountry.health/provider-search/premier-provider-network/.

This policy includes General treatment (Extras) cover for

General treatment legend
TreatmentWaiting period (months)Benefit limits (per 12 months unless otherwise stated)Examples of maximum benefits
General dental2$1,400 per person
(combined limit for general dental, major dental, endodontic & other services - Sub-limits apply)
Periodic oral examination - $54.00
Scale & clean - $89.00
Fluoride treatment - $24.00
Major dental12Surgical tooth extraction - $180.00
Full crown veneered - $800.00
Endodontic12Filling of one root canal - $170.00
Orthodontic12
$3,000 lifetime limit
(Sub-limits apply)
Braces for upper & lower teeth, including removal plus fitting of retainer - $1,000.00
Optical2$300 per personSingle vision lenses & frames - $300.00
Multi-focal lenses & frames - $300.00
Non PBS pharmaceuticals2$500 per person
(combined limit for non pbs pharmaceuticals & vaccinations)
Per eligible prescription - $70.00
Physiotherapy2$1,400 per person
(combined limit for physiotherapy, chiropractic, podiatry, psychology, acupuncture, remedial massage, audiology, chinese medicine, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), osteopathy & speech therapy - Sub-limits apply)
Initial visit - $55.00
Subsequent visit - $45.00
Chiropractic2Initial visit - $55.00
Subsequent visit - $35.00
Podiatry2Initial visit - $40.00
Subsequent visit - $40.00
Psychology2Initial visit - $80.00
Subsequent visit - $80.00
Acupuncture2Initial visit - $35.00
Subsequent visit - $35.00
Remedial massage2Initial visit - $40.00
Subsequent visit - $40.00
Hearing aids12Less than 10 years $1000. Between 10-14 years $1500. 15 years and over $2000. Limit renews every 3 Membership years.Hearing aid - 100% of charge
Blood glucose monitors12$2000 per person 1 appliance(s) every 3 years (combined limit of blood glucose monitors & other services).Per monitor - 100% of charge
Audiology2Combined limit - see PhysiotherapyInitial visit - $50.00
Subsequent visit - $50.00
Ante-natal/Post-natal classes12$60 per personInitial visit - $60.00
Subsequent visit - $60.00
Chinese medicine2Combined limit - see PhysiotherapyInitial visit - $35.00
Subsequent visit - $35.00
Dietetics/dietary advice2Combined limit - see PhysiotherapyInitial visit - $75.00
Subsequent visit - $40.00
Exercise physiology2Combined limit - see PhysiotherapyInitial visit - $50.00
Subsequent visit - $35.00
Eye therapy (orthoptics)2Combined limit - see PhysiotherapyInitial visit - $60.00
Subsequent visit - $60.00
Health management / Healthy lifestyle2$150 per personHealth management - $150.00
Home nursing12$50 per visit or $150 per day up to $1000 per person per Membership year.Initial visit - $50.00
Subsequent visit - $50.00
Occupational therapy2Combined limit - see PhysiotherapyInitial visit - $80.00
Subsequent visit - $40.00
Orthotics (podiatric orthoses)2Combined limit - see PhysiotherapyOrthotics supply & fit - 100% of charge
Osteopathy2Combined limit - see PhysiotherapyInitial visit - $55.00
Subsequent visit - $35.00
Speech therapy2Combined limit - see PhysiotherapyInitial visit - $80.00
Subsequent visit - $40.00
Vaccinations2Combined limit - see Non PBS pharmaceuticalsPer service - $70.00
Rewarding Limits - Once you have held your extras cover with us for one year, we will automatically increase your annual limits for dental (excluding orthodontics) and therapies by $50 per year, up to a maximum of $250. After five years of membership, your limits will increase to $1,650 per person per Membership Year. We honour this loyalty limit for as long as you continuously hold this product. Rewarding limits do not apply to sub-limits.

This policy does not include General treatment (Extras) cover for

General treatment legend
Other treatments - check with your insurer

Other features of this general treatment cover

Health management (Healthy Living benefit) provides benefits towards the costs of metabolic dieticians or nutritionists consultations to assist with weight management, diabetes education consultations, quit smoking programs, skin checks for skin cancers (except where there is a Medicare benefit), bowel screening and bone density tests, a second yearly prostate specific antigen test not covered by Medicare, supermarket tours conducted by a dietitian or other allied health professional qualified to provide nutrition advice, and gym memberships/personal training sessions provided under an approved health management or chronic disease management program. Please contact the insurer for full details.

Ambulance cover

In Western Australia this policy provides:

Emergency: with a waiting period of 1 day, limited to 1 services per year.

Call-out fees:  will not be paid.

Other features of this ambulance cover

This product provides Australia wide cover for one emergency ambulance transport service or on-the-spot emergency treatment per person per Membership Year Australia wide. Other conditions apply – for more information please visit https://www.queenslandcountry.health/cover-options/ambulance-cover/.

For further information about this policy see

https://www.queenslandcountry.health/cover-options/ambulance-cover/

Disclaimer

The information contained in this Private Health Information Statement was provided by the insurer and is intended as general information. It may not take into account your particular circumstances. For information please contact the insurer.

Covered

For information on what is covered under each category, see https://www.privatehealth.gov.au/categories

Restricted

Restricted categories partially cover your hospital costs as a private patient in a public hospital. You may incur significant expenses in a private room or private hospital.

Not Covered

These categories are not covered by this policy.